SAN DIEGAN LEADS LIST OF NATION’S INFLUENTIAL PHYSICIANS

Topol pushes for use of digital tools, medicine tailored to individuals

Dr. Eric Topol, an outspoken San Diego cardiologist who has been pressing for the use of wireless mobile devices and the sequencing of people’s genomes to improve patient care, was named the nation’s most influential physician executive by a pair of major industry magazines Saturday.

Topol, the chief academic officer for Scripps Health, was placed at the top of a list of 50 honorees that includes Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention in Atlanta, and Margaret Hamburg, commissioner of the U.S. Food and Drug Administration.

The 57-year-old Topol was chosen for the honor by editors and readers of Modern Healthcare magazine and a sister publication, Modern Physician.

Modern Healthcare said the selection was based heavily on Topol’s new book, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care.”

Modern Healthcare quoted extensively from the book, noting that Topol “throws down the gauntlet immediately by opening … with this quote by Voltaire: ‘Doctors prescribe medicine of which they know little, to cure disease of which they know less, in human beings of which they know nothing.’ He later quotes George Orwell, who called hospitals the ‘antechamber to the tomb.’ ”

Topol repeated such criticism during an interview Saturday, telling U-T San Diego: “Medicine has operated by a one-size-fits-all rule, doing things like using the same dosage of medicine for most people. We now have tools that let us be precise and to perform more individualized medicine.”

He was referring to wearable digital devices that perform tasks such as monitoring a person’s blood sugar level and the electrical rhythm of the heart. The data from those two experimental devices can be displayed on computers to cellphone screens.

Topol also has replaced his stethoscope with a small, mobile ultrasound device that allows him to see a patient’s heartbeat rather than just listen to it.

In addition to wireless medicine, he is deeply involved in the field of personal genomics, persistently advocating for the sequencing of people’s genes — especially in hopes of diagnosing diseases that haven’t been identified by conventional means.

The genomics industry has grown rapidly because the cost of sequencing a genome has plummeted to about $3,500 and is expected to fall to $1,000 by year’s end. Such sequencing can help scientists develop drugs that more effectively fight and prevent disease, and over time could help doctors tailor medications for individual patients.

Topol recently made headlines for his work on an experimental blood test that might be able to give people up to two weeks’ notice that they are at serious risk of experiencing a heart attack. Scientists hope to eventually develop a wearable device that regularly samples a person’s blood, watching for an increase in the type of cells that indicate a potential heart attack.

Joseph Smith, chief medical officer for the West Wireless Health Institute in La Jolla, said the magazines’ spotlight on Topol “is a well-deserved recognition for a one-of-a-kind physician-scientist-author-executive. Eric has routinely and persistently been agitating for the new, the novel, the needed disruption of health care.”

Michael Marletta, president of The Scripps Research Institute in La Jolla, said: “I’m delighted that Eric has been chosen for this honor. His wide-ranging contributions bring together medicine, technology and science in a way that challenges conventional wisdom.”

Topol is on the board of West Wireless, and he is director of the Scripps Translational Science Institute in La Jolla. He moved to San Diego County in 2006 from the famed Cleveland Clinic, where he directed the Department of Cardiovascular Medicine.

He was a renowned cardiologist and geneticist in Cleveland, where he also developed a reputation for challenging the pharmaceutical industry and various health care practices.

For example, he published a study showing that the widely used painkiller Vioxx increased the risk of heart attack and stroke in some people. More recently, he helped publicize a concern raised by the FDA that some popular statins could contribute to memory loss and/or diabetes in certain patients. Topol has also been a critic of the FDA, calling for the agency to develop better ways to evaluate drugs.

And he has been a central figure in the discussion of many sensitive social and ethical issues involving medicine. After former Vice President Dick Cheney underwent a heart transplant last month, Topol helped start a national dialogue on whether people in their 70s should receive such organs.

But his primary goal in recent years has been promoting the development and widespread use of digital medical devices, and encouraging consumers to get more directly involved in their own health care. When the new book was released, Topol told Medscape Today that he wrote it for consumers “because I recognized that the medical establishment is ultraconservative, which is why it has resisted this digital opportunity.”

“The only way to really take it to the public and to consumers is through their smartphones: It’s their DNA, it’s their social networks, it’s their everything. If they are educated about the opportunity here, they can help drive this. … What will happen when they can go with their data to their doctors and say, ‘Help me; partner with me’? That could set off a whole different way of practicing medicine in the future.”